The Psych Central Report

Helping a Family Member Get Help

Despite the prevalence and our increased understanding and acceptance of mental
illness in society today, many family members still harbor fears and uncertainty
surrounding how to help someone close to them who has a mental illness. Some
of these fears, while understandable, are also irrational - that maybe I'll
"catch" what they have, that it's probably genetic, so I'm going to
get it too, that whatever I'll say to my family member will be the wrong thing.

Understanding with Compassion

These fears for many are grounded in the historical stigma and misinformation
surrounding mental disorders. For decades, anybody who was diagnosed with a
"nervous condition" was often hospitalized as an inpatient for years.
Many were never released, spending most of their lives in hospital wards for
the insane. Doctors didn't really understand why these people were disturbed,
only that their families didn't want to deal with them and their "crazy
behaviors" any longer. So they gladly acquiesced to warehousing family
members in wards designed for a lifetime of living.

But in the past two decades, researchers and doctors have made great strides
in understanding how to administer effective treatments for mental disorders.
These treatments, both medication- and psychotherapy-based, allow nearly anyone
with a mental disorder to lead a full and rich life. The diagnosis of a mental
disorder or condition is no longer a stigmatized sentence to a life in a hospital
ward and of being ignored by one's family.

Yet families often don't know how to handle a family member with a mental disorder,
or one who was once "ill" and is now "better." They don't
understand what caused the disorder in the first place, and are afraid of coming
down with a similar condition over time. It's not surprising this sentiment
is still prevalent. Researchers still have few definitive answers regarding
the causes of mental disorders, although there are many competing theories (including
brain chemistry, personal development and upbringing, physical brain abnormalities,
etc.). However, we still don't know what causes the majority of mental disorders.

Information, then Action

Families would do well to read and learn all they can about the mental disorder
the family member is inflicted with. Websites, such as PsychCentral.com, books,
and informational brochures all contain a wealth of useful information that
can help a person better understand the symptoms, course, scope and treatments
available for a disorder. Knowledge is the key to answering many common questions
and putting to rest many common fears. For instance, mental disorders are not
virus- or bacteria-based, therefore you can't "catch" the mental disorder
afflicting the family member. While there may indeed be genetic indicators and
links, the causal relationships are not well understood for most disorders.
In other words, even if your brother or daughter has schizophrenia, that doesn't
mean you're going to get it too.

Once armed with the knowledge of the particular disorder, it's time to take
action. If the family member isn't already seeking treatment for their concern,
you should help them with finding appropriate care. In America, this often starts
with checking your insurance benefits and seeing how you're covered for mental
health care. Most primary care physicians or family doctors can do an initial,
if cursory, diagnosis of many common mental disorders (such as depression, bipolar
disorder, ADHD, etc.). However, this should only be the first step of treatment.
You should obtain a referral to a mental health care specialist for further
evaluation and a definitive diagnosis (preferably from a psychologist, experience
clinical social worker or the like - someone armed with years worth of differential
diagnostic experience).

That mental health specialist will schedule a one to one and a half hour appointment
with the family member. This intake interview consists of obtaining a lot of
background information, family history, and history of the current problem in
order to make an accurate diagnosis for a mental disorder. If the symptoms or
lifestyle of the family member warrants it, the clinician will also schedule
or refer you to a psychiatrist for a medication evaluation. From there on out,
a treatment plan will be formulated and the family member is well on a path
to recovery.

Privacy and Helping When Help isn't Wanted

Of course, once you help your family member navigate the healthcare maze of
treatment providers, insurance coverage, and diagnostic evaluations, you should
step out of the picture of their care. Respect your family member's privacy.
Most family members, unless they are under-age children, can take care of themselves.
Maybe they just needed that little nudge to get help, or the unconditional support
and acceptance you offered them. It might surprise you, but for many people,
a little kindness and support is all that's necessary.

What if the family member doesn't want to get help? All you can do is share
with them the information you gathered on the condition you believe is afflicting
them, and gently offer them support and a kind word of encouragement. Once.
Just once. The biggest mistake family members make is to give others their unsolicited
advice every time they see the person about what they think is wrong with the
person, and that they need to get help. That's not support, that's nagging.
And nobody likes to be nagged.

You cannot make anybody else do anything they don't want to do. You may think
you can, by punishment, anger, withdrawal of love or attention, etc. But all
you will have done is gained newfound resentment from the family member and
a renewed determination to undermine their own treatment. This is not a healthy
way to approach treatment of any kind and should be avoided at all costs.

With this advice, your family member should be thankful of your support, encouragement,
and guidance in a time when they are likely a little afraid and don't know where
or who to turn to. Sometimes all a person needs is a little guidance and support
to find direction and hope. Because of your unique relationship with your family
member, you are in an ideal position to offer this. Good luck.

Last reviewed:
By John M. Grohol, Psy.D. on
4 Oct 2005
Published on PsychCentral.com. All rights reserved.

Understanding is the soil in which grow all the fruits of friendship. -- Woodrow Wilson